INSERM, TENS, The Enteric Nervous System in Gut and Brain Diseases, IMAD, University of Nantes, Nantes, France.
Institut des Maladies de l'Appareil Digestif, IMAD, CHU Nantes, Hôpital Hôtel-Dieu, Nantes, France.
Sci Rep. 2021 Apr 13;11(1):8077. doi: 10.1038/s41598-021-87158-2.
Gastrointestinal symptoms are frequent in acute adrenal insufficiency. Although digestive symptoms can significantly reduce quality of life, they are rarely described in patients with treated chronic adrenal insufficiency (CAI). We aimed to characterize digestive symptoms in CAI patients. We used the section pertaining functional bowel disorders of the Rome IV questionnaire. A questionnaire was published on the website of the non-profit patient association "Adrenals" (NPPA of CAI patients) for five months. Information on demographics, characteristics of adrenal insufficiency, digestive symptoms and quality of life was collected. The relatives of CAI patients served as a control group. We analyzed responses of 33 control subjects and 119 patients (68 primary adrenal insufficiency (PAI), 30 secondary adrenal insufficiency (SAI) and 21 congenital adrenal hyperplasia (CAH)). Abdominal pain at least once a week over the past 3 months was reported by 40%, 47% and 33% of patients with PAI, SAI and CAH respectively versus 15% for the controls (p = 0.01). Symptoms were consistent with the Rome IV criteria for irritable bowel syndrome in 27%, 33% and 33% of patients respectively versus 6% for the controls (p < 0.0001). Quality of life was described as poor or very poor in 35%, 57% and 24% of patients respectively versus 5% for the controls (p < 0.0001). In conclusion, digestive symptoms are frequent and incapacitating in CAI patients and similar to symptoms of irritable bowel syndrome in 30% of CAI patients. Assessment and management of digestive symptoms should be considered a priority for physicians treating patients with CAI.
胃肠道症状在急性肾上腺功能不全中很常见。尽管消化症状会显著降低生活质量，但在治疗后的慢性肾上腺功能不全（CAI）患者中很少描述这些症状。我们旨在描述 CAI 患者的消化症状。我们使用了罗马 IV 问卷中与功能性肠病相关的部分。该问卷在非营利性患者协会“肾上腺”（CAI 患者的 NPPA）的网站上发布了五个月。收集了人口统计学、肾上腺功能不全特征、消化症状和生活质量的信息。CAI 患者的亲属作为对照组。我们分析了 33 名对照者和 119 名患者（68 名原发性肾上腺功能不全（PAI）、30 名继发性肾上腺功能不全（SAI）和 21 名先天性肾上腺增生（CAH））的反应。过去 3 个月每周至少腹痛一次的患者分别为 PAI、SAI 和 CAH 患者的 40%、47%和 33%，而对照组为 15%（p=0.01）。符合罗马 IV 标准的肠易激综合征症状在分别为 27%、33%和 33%的患者中出现，而对照组为 6%（p<0.0001）。35%、57%和 24%的患者分别描述生活质量较差或极差，而对照组为 5%（p<0.0001）。总之，消化症状在 CAI 患者中很常见且使人丧失能力，在 30%的 CAI 患者中类似于肠易激综合征的症状。评估和管理消化症状应成为治疗 CAI 患者的医生的首要任务。
